Assisted Living is a type of group living for seniors. Residents live in a private apartment or room, and spend most of the day in common spaces with planned activities and group, restaurant style meals. Residents of Assisted Living can be as young as 60 years old, but on a practical basis most are in their early 70s and up.
Here are the major components of an Assisted Living community:
There are over 80 Assisted Living communities on Long Island and in Queens. They are in a variety of settings – from Main Streets in the many small towns of Long Island, to high rises in more urban areas of Western Nassau and Eastern Queens, and in beautiful quiet settings in more suburban or rural areas. There are (AL) options everywhere on our Island, and there is a type of Community to meet most wants and needs.
Personal Living Space
Most Long Island Assisted Living communities resemble, on the surface, a small resort hotel. Each community houses about 100 residents. Each resident has a room or apartment. Some rooms are modest and are shared with another resident. Most are typical private apartments – and some are quite luxurious. The apartments might be studios, one bedroom, or even two-bedroom apartments. Each is completely handicapped accessible and ADA compliant. Each have private bathrooms with showers, and almost all have kitchenettes- fridge/freezer, sink, and space for a microwave and perhaps a coffee maker.
Common Community Space
Just like in a resort hotel or a cruise ship, the ‘action’ in an Assisted Living community is all in common spaces. The Assisted Living community serves all meals in common, so there is typically a large dining room where residents can order three meals a day from a menu, restaurant style. In addition, many communities have a smaller, more casual dining space where residents can pick up snacks and beverages during the day. Most Assisted Living communities, too, have other common and sometimes specialized rooms for exercise, movies, music, arts and crafts, lectures, reading, and socializing. Most residents in Assisted Living spend at least part of their day in the common activities of the community, and most communities have at least ten activities to choose from each day.
The “Assistance” in Assisted Living references help with the Activities of Daily Living (ADLs) that is offered in every Assisted Living community. These are activities that everyone does, like showering, dressing, toileting, and getting up and going in the morning. Some seniors require virtually no ADL assistance, while others require frequent help during the day. These services, which are delivered by aides and supervised, typically, by one nurse for the building, are delivered by the management of the community – although some people will bring in a trusted aide to deliver the care.
There are at least 80 communities (facilities) on Long Island that can be called Assisted Living. Among these, there is a wide selection. Some are quite simple and modest, while others are the equivalent of a four-star resort. Some have pools, hair salons, libraries, dedicated arts and crafts rooms, outdoor walking paths, movie theaters, and casual dining and snack bistros. Most bring in entertainers, offer local transportation, and take local day trips. Virtually all offer some options for religious services. All communities provide space for physicians to come to the community – both GPs and specialists. Other communities are more modest, with a couple of common rooms serving multiple purposes. Just like day-to-day life on Long Island, there are options for people with a wide variety of interests. Although there are several factors that impact the level of amenities in a community, budget is the main difference.
In Assisted Living communities on Long Island, there are two basic cost structures. The first is “Rent + Care”, while the second is “All Inclusive”.
The Rent + Care model, which is by far the most common, bills residents two charges each month. The first is for rent of the physical space, all common activities, food, snacks, and access to medical services. This is a fixed charge, and residents typically pay a charge based on the size of their room or apartment. The second charge in the Rent + Care model is for personal care services, supporting the resident’s need for help with the Activities of Daily Living. These services are delivered by aides, are scheduled to the extent they can be scheduled, and are supervised typically by one nurse for the building. Again in most communities there is a variable monthly charge for care, depending on the needs of the senior. Some residents do not have a charge for Care – they require no assistance with ADLs. Others require care throughout the day, and the Care charge can be significant.
On Long Island, the Rent cost ranges from $3,000 to over $10,000 per month. The Care charge ranges from $0 to $4, a month.
The second billing model for Assisted Living billing is the All-Inclusive model. On Long Island and Queens, only 6-8 communities follow this model. The All-Inclusive model has the advantage of providing a predictable charge each month. Typically, the All-Inclusive communities accept people with mild to moderate ADL needs. Most All-Inclusive communities do not offer the amenities available in the more expensive Assisted communities. However, for the senior and family with modest, middle-class expectations these few communities can be very good options.
On Long Island, the All-Inclusive communities typically charge $4,000 -$5,500 per month.
Most Assisted Living communities on Long Island are private pay – the community sends a bill each month to the family or to the senior, and the bill is paid directly. Most bills are for a very predictable amount, with charges for extra services, like hair dressing and a trip which required a separate ticket (like a Broadway show) the only ‘extras. The family would collect money from various sources, like social security, Long Term Care insurance, IRAs, pensions, Veteran’s Aid and Attendance payments, and then pay the community each month. Medicare and health insurance policies are not accepted for payment.
There are about 12 Communities on Long Island and in Queens that accept Medicaid to pay for a portion of the Care provided to a senior. If the senior lived a middle-class life or higher, then they would more typically find commercial (fee for service) Assisted Living Communities like Bristal, Atria, and Sunrise options most comfortable. It is in these Communities that they will find people and activities they recognize from their previous residence. If the senior lived a working-class life, or was poor, then they would likely to feel comfortable in the surroundings of some of the nicer Medicaid funded facilities, like Amber Court and Braemar.